Early Postoperative Patient-Reported Outcomes of Sarcopenia Versus Nonsarcopenia in Patients Undergoing Video-Assisted Thoracoscopic Surgery for Lung Cancer

Ann Surg Oncol. 2025 Feb;32(2):801-810. doi: 10.1245/s10434-024-16140-9. Epub 2024 Aug 31.

Abstract

Background: To compare early postoperative patient-reported outcomes between sarcopenic and nonsarcopenic patients undergoing video-assisted thoracoscopic surgery (VATS) for lung cancer.

Methods: The data used in this study were acquired from a longitudinal prospective study (CN-PRO-Lung 1) between November 2017 and January 2020. Skeletal muscle index was measured at L3 vertebral level on preoperative computed tomography to identify sarcopenia based on an established threshold. Symptoms severity and status of functional impairments were reported as proportions of patients with clinically relevant moderate-to-severe scores on 0-10 scales, which were measured by using the MD Anderson Symptom Inventory-Lung Cancer at baseline, daily postoperative hospitalization, and weekly after discharge up to 4 weeks. Symptom severity, functional status, and postoperative clinical outcomes were compared between the sarcopenia and nonsarcopenia groups.

Results: This study included 125 patients undergoing VATS for lung cancer. Sarcopenia was identified in 34 (27.2%) patients. Sarcopenic patients reported more moderate-to-severe pain (P = 0.002) at discharge and more moderate-to-severe fatigue (P = 0.027) during the 4 weeks after discharge. Besides, sarcopenic patients had a longer recovery time from both pain (P = 0.002) and fatigue (P = 0.007) than nonsarcopenic patients. Meanwhile, no significant between-group difference was found in the postoperative clinical outcomes (all P > 0.05).

Conclusions: Sarcopenic patients undergoing VATS for lung cancer may have more pain and fatigue, as well as longer symptoms recovery time than nonsarcopenic patients during the early postoperative period.

Keywords: Lung cancer; Patient reported outcome; Quality of life; Sarcopenia; Video assisted thoracoscopic surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Fatigue / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Postoperative Complications* / etiology
  • Prognosis
  • Prospective Studies
  • Sarcopenia* / complications
  • Sarcopenia* / etiology
  • Thoracic Surgery, Video-Assisted* / methods